Provider Demographics
NPI:1487752663
Name:RAFFA, JOSEPH J (OD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:J
Last Name:RAFFA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4344 WOODLANDS BLVD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-2801
Mailing Address - Country:US
Mailing Address - Phone:303-688-3636
Mailing Address - Fax:303-688-1036
Practice Address - Street 1:4344 WOODLANDS BLVD
Practice Address - Street 2:SUITE 160
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-2801
Practice Address - Country:US
Practice Address - Phone:303-688-3636
Practice Address - Fax:303-688-1036
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT1688152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO08916884Medicaid
CO4293.3Medicare ID - Type UnspecifiedMEDICARE
CO08916884Medicaid